Reactive oxygen species in follicular fluid may serve as biochemical markers to determine ovarian aging and follicular metabolic age

Introduction: The aim of this study was to evaluate the role of oxidative stress in the process of ovarian aging. Methods: Follicular fluid (FF) from two randomly selected sibling follicles was collected from women undergoing in-vitro fertilization and tested for hydrogen peroxide (H2O2) levels. Results: Group A consists of seven women with whom each of the two sibling separate follicle yielded an oocyte that was later discordantly developed to a low-and top-quality embryo. Group B consists of 13 patients in whom one of the sibling follicle yielded an oocyte while the other did not (empty follicle). High-quality embryos were derived from follicles with lower H2O2 levels compared to follicles from which poor-quality embryos developed (1.004 units +/- 0.260 versus 1.145 units +/- 0.236, p<0.02). H2O2 levels were significantly higher (0.951 units +/- 0.233 versus 0.623 units +/- 0.309, p<0.001) in sibling follicles containing oocyte compared to empty follicles. Conclusion: During the process of ovarian ageing, there might be a gradual increase in H2O2 level in the follicle. Finally, when the follicle ages and becomes empty of oocyte H2O2 levels drops significantly. Therefore, H2O2 levels in FF may serve as a possible marker to determine ovarian aging and follicular metabolic age.